Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boise Outdoor OT

Organization Pediatric Occupational Therapist · NPI 1619643590

Boise Outdoor OT is a Pediatric Occupational Therapist in Garden City, Idaho. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

522 E 40th St
Garden City, ID 83714-6358
Phone: (323) 640-2305
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X

Record details

NPI number1619643590
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daniele Fallon — Occupational Therapist · (208) 918-2657
NPI enumeratedAugust 19, 2021
Last updated in NPPESNovember 15, 2021
Certification dateNovember 15, 2021
Mailing address522 E 40th St, Garden City, ID 83714-6358